scholarly journals Volvulus of the Sigmoid Colon during Pregnancy: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Enzo Fabrício Ribeiro Nascimento ◽  
Michelle Chechter ◽  
Fábio Piovezan Fonte ◽  
Nara Puls ◽  
Juliana Santos Valenciano ◽  
...  
Keyword(s):  
Sigmoid Colon ◽  
Colonic Obstruction ◽  
Rectal Stump ◽  
Sigmoid Volvulus ◽  
Fetal Mortality ◽  
Diffuse Peritonitis ◽  
Abdominal Radiography ◽  
Proximal Colostomy ◽  
Colon Volvulus ◽  
Clinical Conditions

Colonic obstruction due to sigmoid colon volvulus during pregnancy is a rare but complication with significant maternal and fetal mortality. We describe a case of sigmoid volvulus in a patient with 33 weeks of gestation that developed complete necrosis of the left colon.Case. 27-year-old woman was admitted with 3 days of abdominal distention, vomit, and the stoppage of the passage of gases and feces. She was admitted with poor clinical conditions with septic shock, acute respiratory distress syndrome, and signs of diffuse peritonitis. Abdominal radiography showed severe dilation of the colon with horseshoe signal suggesting a sigmoid volvulus, pneumoperitoneum and we could not we could not identify fetal heartbeats. With a diagnosis of complicate sigmoid volvulus she was underwent to the laparotomy where we found necrosis of all descending colon due to double twist volvulus of the sigmoid. We performed a colectomy with a confection of a proximal colostomy, and closing of the rectal stump. Due to an uncontrollable uterine bleeding during cesarean due, it was required a hysterectomy. The patient had an uneventful postoperative course thereafter and was discharged on a regular diet on the 15th postoperative day.

Endometrioma Causing Near-Complete Obstruction of the Sigmoid Colon

2021 ◽  
pp. 000313482199506
Author(s):  
Kaitlyn Stevens ◽  
Tarik Wasfie ◽  
Carolyn Haus
Keyword(s):  
Sigmoid Colon ◽  
Transvaginal Ultrasound ◽  
Colonic Obstruction ◽  
Gastrointestinal Symptoms ◽  
Rectal Stump ◽  
Muscularis Propria ◽  
Reproductive Age ◽  
Ca 125 ◽  
En Bloc ◽  
Intestinal Endometriosis

Endometriosis is characterized by extra-uterine endometrial gland and stroma implantation. Intestinal endometriosis is believed to affect about one-third of patients with endometriosis 4 ; 72-95% of patients experience recto-sigmoid involvement. 2 , 3 Occasionally, endometriotic lesions precipitate mass effect or infiltrate the bowel wall, mimicking a neoplasm. In the index case, we evaluated a G0P0 41-year-old perimenopausal female with near obstructing sigmoid endometrioma, clinically presented, investigated, and managed in the lines of sigmoid colon carcinoma. Computed Tomography revealed marked distention of the distal descending and proximal sigmoid colon to the level of a [possible] intraluminal mass. CA-125 was 247.4. Transvaginal ultrasound revealed a heterogeneous irregularity adjacent the left adnexa. Flexible sigmoidoscopy to 12-15 cm was unable to pass liquid or visualize the lumen secondary to extrinsic colonic obstruction. She underwent exploratory laparotomy with sigmoidectomy, oversew of rectal stump, and descending colostomy. Left fallopian tube and ovary were adherent to sigmoid mass, therefore, removed en-bloc. Histopathological report revealed extensive endometriosis involving the muscularis propria and serosal surface of colon and ovary, with fibrinous serosal adhesions of the sigmoid colon. While inconsistent clinical presentation, similar radiographic features, and colonoscopy with other inflammatory or malignant lesions of the bowel makes the preoperative diagnosis challenging, colonic endometriosis is to always be considered as one of the differential diagnoses in reproductive age women with patterned, cyclic gastrointestinal symptoms, and intestinal masses of uncertain etiology or diagnosis.

scholarly journals UNUSUAL PRESENTATION OF ACUTE INTESTINAL OBSTRUCTION DUE TO TRANSVERSE COLON VOLVULUS IN LATE PREGNANCY

2020 ◽  
Vol 7 (3) ◽  
pp. 106-109
Author(s):  
Muad Gamil M. Haidar ◽  
Nuha Ahmed H. Sharaf ◽  
Mayada Mohamed Al-Dankali
Keyword(s):  
Intestinal Obstruction ◽  
Transverse Colon ◽  
Primary Anastomosis ◽  
Colonic Obstruction ◽  
Late Pregnancy ◽  
Abdominal Ultrasound ◽  
Fetal Mortality ◽  
Contributing Factors ◽  
Colonic Volvulus ◽  
Colon Volvulus

Transverse colon volvulus is the rarest type of colonic volvulus, with a higher morbidity and mortality rate. In pregnancy, intestinal obstruction due to transverse colon volvulus is rare and seldom reported, and its timely diagnosis can be difficult. We report an unusual case of transverse colon volvulus in a young female at late-term pregnancy. A 28-years-old, pregnant woman, gravida 2, para 1, at 34 weeks of gestation, presented with progressive abdominal pain and distention, commencing about 12 hours prior to admission, associated with vomiting and obstipation.  Vital signs were stable. However, the abdomen was asymmetrically hugely distended.  The initial abdominal ultrasound showed a single viable intrauterine fetus and dilated loops of bowels. As fetal distress progressed throughout the admission, a laparotomy was performed, which revealed an unexpected transverse colonic volvulus. Resection of the twisted segment and primary anastomosis were performed, followed by a cesarean section to deliver the baby. The mother made a satisfactory recovery. Although this patient’s preoperative clinical findings suggested colonic obstruction, the diagnosis of transverse colonic volvulus was only made intraoperatively and has seldom been previously described. Chronic constipation, the enlarging uterus, and the anatomical redundancy of the transverse colon may have been contributing factors. Transverse colon volvulus in late pregnancy is uncommon. Early diagnosis and prompt surgical intervention can significantly minimize maternal and fetal mortality.

scholarly journals Risk factors and surgical management of sigmoid volvulus among patients attending Al-Karama Teaching Hospital of Iraq

2019 ◽  
Vol 6 (3) ◽  
pp. 862
Author(s):  
Mohammed Hillu Surriah ◽  
Amine Mohammed Bakkour ◽  
Nidaa Ali Abdul Hussain
Keyword(s):  
Sigmoid Colon ◽  
Teaching Hospital ◽  
Chronic Constipation ◽  
Abdominal Distension ◽  
Sigmoid Volvulus ◽  
High Fiber ◽  
Presenting Symptoms ◽  
Fiber Diet ◽  
High Fiber Diet ◽  
Colon Volvulus

Background: Sigmoid volvulus is defined as torsion of the sigmoid colon around its mesenteric axis, which leads to acute large intestine obstruction, which, if left untreated, often results in life-threatening complications, such as bowel ischemia, gangrene and perforation. The aim of this study was to analyse sigmoid colon volvulus when its presented as a surgical emergency.Methods: This was a prospective study of 25 patients presented with the features of strangulated sigmoid colon volvulus to Al-Karama Teaching Hospital (surgical casualty) from March 2014 to March 2018. Eighteen patients (72%) were males and seven patients (28%) were females. The age of the patients ranged from 20-70 years. The main risk factor was chronic constipation, laxative dependency and high fiber diet. The main presenting symptoms and signs were absolute constipation, generalized abdominal distension, tenderness, tachycardia and fever. The patients were investigated by plain abdominal X-ray and haematological investigations.Results: Among the 25 patients, 13 had distended gangrenous sigmoid colon volvulus, 9 out of the remaining 12 patients were discovered to have distended non-gangrenous sigmoid colon volvulus of the rest 3 patients, 2 were found to have Ileo-sigmoid knotting and the last patient had a perforated gangrenous sigmoid colon volvulus. Four patients developed postoperative complications and one patient died.Conclusions: Volvulus of the sigmoid colon is more predominant in males. Middle age individuals seem to be the most affected group by sigmoid colon volvulus. Majority of patients with sigmoid colon volvulus have history of chronic constipation, laxative dependency and high fiber diet.

scholarly journals AN EXPERIENCE OF SIGMOID COLON VOLVULUS AT EMMERGENCY WARD LRH

2011 ◽  
Vol 6 (2) ◽  
pp. 798-803
Author(s):  
USMAN ALI ◽  
NAIK ZADA ◽  
ASADULLAH ◽  
MOHAMMAD SIYAR ◽  
ABID ALI
Keyword(s):  
Sigmoid Colon ◽  
Primary Anastomosis ◽  
Standard Procedure ◽  
Wound Dehiscence ◽  
Sigmoid Volvulus ◽  
Full Blood Count ◽  
Rectal Tube ◽  
Abdominal Colic ◽  
Colon Volvulus ◽  
Age Range

BACKGROUND: Sigmoid volvulus is a serious condition due to rotation of sigmoid colon. Volvulusoften presents with abdominal colic and distention. It can be managed conservatively by colonoscopicdecompression, followed by optimization of patient and finally surgical procedure. The present studywas based on the comparison of resection of sigmoid colon and double barrel colostomy or resection andprimary anastomosisOBJECTIVE: Objective of the study was to compare the results of primary anastomosis and colostomyin patients presenting with sigmoid volvulus.METHODOLOGY: In this study a total of 48 patients with sigmoid volvulus coming to Accident &Emergency Department were included. All the patients were examined and investigated. After diagnosisbased on x-ray erect abdomen all the patients were admitted in Accident and Emergency ward. Afteradmission Full Blood count, urea, sugar, S. Electrolysis and ECG were also performed. Patients werecatheterized and a nasogastric tube passed for gastric decompression. All the patients were givenintravenous fluids antibiotics and prepared for surgery as facilities for colonoscopic sigmoidscopicdecompression were not available and decompressions by rectal tube was unsuccessfulRESULTS: Among the cases with sigmoid volvulus there were 36 males and 12 were females. Majority28 cases were in age range of 61-70 years. Eight patients had gangrene of sigmoid colon, 23 patients hadresection and colostomy while 20 had resection and primary anastomosis. Among the postoperativecomplications, 05 patients had wound infection and 01 wound dehiscence. Two patients died because ofsepsis and cardiopulmonary complications.CONCLUSION: Patients presenting as acute abdomen should have urgent laparotomy as soon aspossible. Decompression by colonoscope is the gold standard procedure for stable patients with sigmoidvolvulus. Sigmoidectomy and primary anastomosis is the procedure of choice as it not only avoidssecond admission and operation, but it also avoids the side effects and care of stoma, which is majorcause of morbidity and mortality.

The role of the anatomy of the sigmoid colon in developing sigmoid volvulus: a cross-sectional study

2012 ◽  
Vol 35 (3) ◽  
pp. 249-257 ◽  
Author(s):  
Olusegun Isaac Alatise ◽  
Olusegun Ojo ◽  
Polycarp Nwoha ◽  
Ganiyat Omoniyi-Esan ◽  
Abidemi Omonisi
Keyword(s):  
Sigmoid Colon ◽  
Cross Sectional Study ◽  
Sigmoid Volvulus ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals A Symptomatic Coffee Bean: Acute Sigmoid Volvulus

2017 ◽  
Vol 11 (2) ◽  
pp. 348-351 ◽  
Author(s):  
Michael Scharl ◽  
Luc Biedermann
Keyword(s):  
Sigmoid Colon ◽  
Guide Wire ◽  
Outlet Obstruction ◽  
Primary Treatment ◽  
Sigmoid Volvulus ◽  
Coffee Bean ◽  
Diagnostic Colonoscopy ◽  
X Ray ◽  
Abdominal Emergency ◽  
Distended Abdomen

An acute sigmoid volvulus is due to the torsion of the sigmoid colon around its mesenteric axis. It mainly occurs in elderly patients and represents an abdominal emergency requiring urgent treatment. A 53-year-old male patient with severe craniocerebral injury and traumatic subarachnoidal bleeding 3 weeks prior presented on the ward with distended abdomen without abdominal pain, muscular defense, or resistances. He featured large volume diarrhea within the last few hours without signs of bleeding. A plain abdominal X-ray demonstrated a coffee bean sign indicating a sigmoid volvulus. A consequent CT scan of the abdomen revealed a deep outlet obstruction with massively dilated, elongated and twisted loop of the sigmoid colon and no signs of perforation. We performed emergency colonoscopy under the assumption of an acute sigmoid volvulus. After careful insertion of the endoscope completely refraining from insufflation of air or CO2, endoscopic reposition of the sigma could be achieved and a colonic drainage was placed over an inserted guide wire up to the proximal transverse colon. No relapse occurred and a diagnostic colonoscopy after 4 weeks revealed no tumor or polyps. Our report describes a classic case of acute sigmoid volvulus and undermines the potential of colonoscopy as conservative primary treatment of choice.

scholarly journals Large Bowel Obstruction Due to a Big Gallstone Successfully Treated with Endoscopic Mechanical Lithotripsy

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Marco Balzarini ◽  
Laura Broglia ◽  
Giovanni Comi ◽  
Calcedonio Calcara
Keyword(s):  
High Risk ◽  
Sigmoid Colon ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Large Bowel ◽  
Colonic Obstruction ◽  
Gallstone Ileus ◽  
Large Bowel Obstruction ◽  
Mechanical Lithotripsy ◽  
Mechanical Bowel Obstruction

Colonic gallstone ileus in an uncommon mechanical bowel obstruction caused by intraluminal impaction of one or more gallstones. The surgical management of gallstone ileus is complex and is potentially of high risk. There have been reports of gallstone extractions using various endoscopic modalities to relieve the obstruction. In this report we present the technique employed to successfully perform a mechanical lithotripsy and extraction of a large gallstone embedded in a sigmoid colon affected by diverticular stenosis. We passed through the stenosis with a 11.3 mm videoscope with 3.7 mm channel. A large lithotripsy extraction basket was used to catch and break up the stone and fragments were removed using the same basket. The patient was discharged asymptomatic three days after the procedure. Using appropriate devices mechanical lithotripsy is a safe and effective method to treat colonic obstruction and avoid surgery in the setting of gallstone ileus even in case of big stones.

A 40-Year-Old Woman With Cauda Equina Syndrome Caused by Rectothecal Fistula Arising From an Anterior Sacral Meningocele

Neurosurgery ◽  
2010 ◽  
Vol 67 (5) ◽  
pp. E1464-E1475 ◽  
Author(s):  
Eric Bergeron ◽  
Alain Roux ◽  
Jacques Demers ◽  
Laurent E Vanier ◽  
Lynne Moore
Keyword(s):  
Cauda Equina Syndrome ◽  
Unusual Case ◽  
Clinical Presentation ◽  
Cauda Equina ◽  
Rectal Stump ◽  
Sigmoid Resection ◽  
Abdominal Approach ◽  
Satisfactory Outcome ◽  
Proximal Colostomy ◽  
Anterior Sacral Meningocele

Abstract BACKGROUND AND IMPORTANCE: We present a rare case of a rectothecal fistula arising from an anterior sacral meningocele in a patient with Currarino syndrome. CLINICAL PRESENTATION: The patient was a 40-year-old woman presenting with cauda equina syndrome and ascending meningitis. The meningocele was removed using an anterior abdominal approach. A sigmoid resection was performed with rectal on-table antegrade lavage followed by closure of the rectal fistula, closure of the rectal stump, and proximal colostomy. Closure of the sacral deficit was carried out by suturing a strip of well-vascularized omentum and fibrin glue. CONCLUSION: We discuss the characteristics, management, and evolution of this unusual case. Prompt surgical management using an anterior approach, resection of the sac, closure of the sacral deficit, and fecal diversion resulted in a satisfactory outcome.

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